Director, Market Strategic Initiatives and Vendor Performance

Commonwealth Care Alliance (CCA) is a nonprofit, mission-driven health plan and care delivery organization designed for individuals with the most significant needs. As an affiliate of CareSource, a nationally recognized nonprofit managed care organization with over 2 million members across multiple states, CCA serves individuals enrolled in Medicaid and Medicare in Massachusetts through the Senior Care Options and One Care programs and its care delivery enterprises. CCA is dedicated to delivering comprehensive, integrated, and person-centered care, powered by its unique model of uncommon care, which yields improved quality outcomes and lower costs of care.

Job Summary:

The Director, Market Strategic Initiatives and Vendor Performance oversees the delivery of critical services, including DME vendor management, home modifications, and wheelchair repair. This role focuses on improving the product and member experience, ensuring regulatory compliance, and supporting operational excellence to enable safe community living for members.

Essential Functions:

• Lead initiatives to improve member interactions with plan services and benefits.
• Support the alignment of products and services with member needs, with attention to equity, accessibility, and quality.
• Monitor and evaluate the end-to-end product service experience, identifying opportunities for improvement and escalation as appropriate.
• Manage vendor relationships for DME , ensuring high-quality, quality service delivery and adherence to contractual expectations.
• Establish and monitor service level agreements (SLAs) with vendors, focusing on timely delivery of medical equipment.
• Oversee the development of policies and procedures related to DME procurement, repair, and replacement services.
• Manage vendor relationships for home modification services.
• Establish and monitor service level agreements (SLAs) with vendors, focusing on timely and quality delivery of home modifications.
• Oversee the development of policies and procedures related to home modifications.
• Manage vendor relationships as the primary point of contact for wheelchair repair vendors, ensuring high-quality service delivery and adherence to contractual obligations.
• Establish and monitor service level agreements (SLAs) with vendors, focusing on timely repair and maintenance of wheelchairs.
• Oversee the development of policies and procedures related to wheelchair repair services.
• Provide day-to-day leadership and guidance to provider network process leads, including coaching and performance support.
• Partner with internal stakeholders, including operations, compliance, and clinical teams, to support initiative execution and alignment with organizational goals.
• Serve as a key point of contact for vendor and partner relationships, escalating risks or issues as needed.
• Assist with communication and coordination with external stakeholders, including vendors and regulatory partners.
• Perform any other job related duties as requested.

Education and Experience:

• Bachelor's in healthcare management, business, or a related field required
• Master's or MBA in healthcare management, business, or a related field preferred
• Equivalent years of relevant work experience may be accepted in lieu of required education
• Seven (7) years of experience in healthcare operations, member services, or product experience roles
  required
• Experience supporting vendor management and service delivery improvement initiatives required required
• Working knowledge of DME services, healthcare regulations, and compliance requirements required
• Strong communications, analytical, and organizational skills required

Competencies, Knowledge and Skills:

• Strategic Thinking: Ability to contribute to plans aligned with organizational goals.
• Operational Effectiveness: Ability to support process improvements and tack measurable results.
• Relationship Building: Builds effective working relationships internally and externally.
• Member-Centric Focus: Demonstrates commitment to improving member experience and outcomes.
• Knowledge of Medicare Advantage rules and regulations.
• Knowledge of MassHealth, or other Medicaid program regulations.

Licensure and Certification:

• None

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time
• May be required to work additional hours and/or outside normal business hours as needed to meet deadlines.
• Travel is not typically required

Compensation Range:
$113,000.00 - $197,700.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type:
Salary

Competencies:
- Fostering a Collaborative Workplace Culture
- Cultivate Partnerships
- Develop Self and Others
- Drive Execution
- Influence Others
- Pursue Personal Excellence
- Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

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